Rolacin

Indications

Clarithromycin is an antibiotic used to treat bacterial infections, including:

• Throat, sinus and ear infections
• Chest infections such as bronchitis and pneumonia, including atypical pneumonia
• Skin and soft tissue infections
• Helicobacter pylori infection of the stomach (linked to ulcers), together with other medicines
• Some mycobacterial infections, under specialist care

It is often chosen for people who are allergic to Penicillin.

How It Works

It stops bacteria from making the proteins they need to grow, so the infection is controlled and the body can clear it.

Dosage and Administration

Adults: usually 250 mg twice a day, increased to 500 mg twice a day for more severe infections, for 7 to 14 days. Modified-release tablets: usually 500 mg once a day, taken with food. H. pylori: 500 mg twice a day for 7 to 14 days, together with other medicines, as prescribed. Children: by body weight, as prescribed. Finish the full course. People with severe kidney problems may need a lower dose.

Interactions

Clarithromycin interacts with many medicines. Tell the doctor or pharmacist about everything you take, especially:

• Simvastatin and Lovastatin (must not be taken together); Atorvastatin at a limited dose only
• Colchicine, Ergotamine, Domperidone, Ticagrelor and Ranolazine (must not be taken together)
• Medicines that affect heart rhythm, such as Amiodarone, Quinidine and some antipsychotics
• Warfarin, Digoxin, Carbamazepine, Theophylline, Ciclosporin and Tacrolimus: levels or effects may increase
• Midazolam and some sleeping tablets: may cause more drowsiness
• Some diabetes medicines (such as Glibenclamide) and insulin: risk of low blood sugar

Contraindications

• Allergy to Clarithromycin, Erythromycin, Azithromycin or other macrolides
• History of QT prolongation or abnormal heart rhythm, or low blood potassium
• Severe liver failure together with kidney impairment
• Taking any of the medicines listed above as not to be taken together

Side Effects

Common: taste changes (metallic or bitter), nausea, diarrhoea, stomach pain, indigestion, headache and difficulty sleeping.

Get urgent medical help if you have:

• Fast, pounding or irregular heartbeat, fainting
• Severe or bloody watery diarrhoea, during or after treatment
• Yellow skin or eyes, dark urine or severe stomach pain
• Blistering or peeling skin, or swelling of the face, lips or throat, or difficulty breathing

Pregnancy and Lactation

Not recommended in pregnancy, especially in the first 3 months, unless the doctor considers there is no better choice. It passes into breast milk; the doctor will decide whether it is suitable while breastfeeding, and the baby should be watched for diarrhoea or thrush.

Precautions and Warnings

• Tell the doctor about heart rhythm problems, liver or kidney disease, or myasthenia gravis.
• Older people and those on many medicines are at higher risk of interactions.
• Long use can allow other germs, such as fungi, to grow.
• Do not share antibiotics or keep leftovers for later.

Overdose

Too much may cause vomiting, diarrhoea and stomach pain, and can affect heart rhythm. Contact a doctor or hospital.

Therapeutic Class

Antibiotic: macrolide.

Storage

Store below 30°C in a dry place, away from light and out of the reach of children. Mixed oral suspension: do not put in the fridge; use within the number of days stated on the pack.